80岁以上高龄患者关节置换围手术期风险因素探讨  

Risk Factors in Perioperative Arthroplasty in Elderly Patients over 80 Years

作　　者：潘凌霄[1] 林剑浩[1] 张恒[1] 李儒军[1] 钟群杰[1] 周殿阁[1] 董丹丹[2] 孙纽云[2] 

机构地区：[1]北京大学人民医院,北京100044 [2]卫生部医院管理研究所医疗安全与风险管理中心,北京100083

出　　处：《中国卫生质量管理》2013年第1期12-16,共5页Chinese Health Quality Management

基　　金：中澳卫生与艾滋病项目(CAHHF)基金HSS104"医疗安全风险管理与预警监测体系研究"子课题

摘　　要：目的探讨80岁以上患者行关节置换围手术期的风险因素。方法选定2009～2011年在北京大学人民医院行髋、膝关节置换及翻修术的80岁以上患者,对年龄、性别、体重指数(BMI)、术前合并症、麻醉方式、手术时间、术中出血、术后输血等对术后不良情况的影响因素进行分析。结果 120例患者中,术前存在内科合并症94例(78.33%),术后出现不良情况34例(28.3%)。合并呼吸系统疾病为术后不良情况的危险因素;对于高龄、全麻、合并呼吸系统疾病以及手术时间较长的患者,术后更需要进入ICU治疗。Objective To investigate risk factors in perioperative arthroplasty in elderly patients over 80 years. Method From 2009 to 2011, patients over 80 years with arthroplasty in the People＇s Hospital of Peking University were recruited. Age, gender, body mass index { BMI ） , preoperative complications, anesthesia, surgery time, blood loss, postoperative blood transfu- sion were measured and evaluated. Result Among the enrolled 120 patients, 94 cases had preoperative medical complications （78.33%） , 34 cases occurred adverse outcomes postoperatively （28.3%）. Respiratory complications were risk factors of ad- verse outeomes. Preoperative respiratory complications are risk factors for adverse outcomes. Senile patients with general anesthe- sia, respiratory complications and prolonged operation duration may need ICU treatment.

关 键 词：高龄 关节置换 危险因素 

分 类 号：R687.4[医药卫生—骨科学]